scholarly journals A study on the clinical profile of dermatoses induced by topical corticosteroids

2021 ◽  
Vol 7 (2) ◽  
pp. 177
Author(s):  
Vontela Rohit ◽  
S. Rajesh Reddy ◽  
Narendar Gajula ◽  
Karing Deepthi
Keyword(s):  
Side Effects ◽  
Clinical Presentation ◽  
Tertiary Care ◽  
Topical Steroid ◽  
Age Group ◽  
Over The Counter ◽  
Study Region ◽  
Topical Corticosteroids ◽  
Wide Range ◽  
Tinea Incognito

<p class="abstract"><strong>Background:</strong> Topical corticosteroids (TC), commonly used for a wide range of skin disorders, are associated with many side effects with their overuse, abuse and over-the-counter use as a cosmetic. This article aims to study clinical presentation of various dermatoses induced by abuse of TC in order to bring awareness among patients and practitioners to use topical corticosteroids with utmost caution.</p><p class="abstract"><strong>Methods:</strong> This study was conducted at DVL department of a tertiary care teaching hospital over 23 consecutive months. A total of 200 consecutive patients of all ages and both genders with topical steroid induced dermatoses were included in the study. A detailed clinical evaluation was undertaken, data was then recorded and analysed.</p><p class="abstract"><strong>Results:</strong> Majority of the patients were females (56%). Most common age group was 20-29 years (42%). Majority used TC as a remedy for dermatophytosis (38%), followed by use as a fairness/cosmetic cream (20%). Most of patients (29.5%) used TC for 6 months duration. Most commonly used TC formulation was 0.05% clobetasol propionate (37.5%). Majority patients (62%) did not have a valid prescription of which 47% used TC on Quacks’s advice. The most common side effects encountered were tinea incognito (33%), steroid-induced acne (20.5%), hyperpigmentation (14.5%), and hypopigmentation in 22 (11%).</p><p class="abstract"><strong>Conclusions:</strong> Present study highlights irrational prescription of TC by non-dermatologists for dermatophytosis which are very common in this particular study region and emphasizes the need to educate patients about serious adverse effects of TC abuse.</p>

scholarly journals Topical steroid abuse on face: a prospective study from a tertiary care centre of north India

2017 ◽  
Vol 3 (3) ◽  
pp. 433
Author(s):  
Asha Nyati ◽  
Anil Kumar Singhal ◽  
Devendra Yadav ◽  
Manoj Kumar Sharma
Keyword(s):  
Side Effects ◽  
Adverse Effects ◽  
Tertiary Care ◽  
Topical Steroid ◽  
North India ◽  
Topical Steroids ◽  
Tertiary Care Centre ◽  
Dermatology Department ◽  
Steroid Abuse ◽  
Topical Corticosteroids

<p class="abstract"><strong>Background:</strong> Topical corticosteroids (TCS) are widely misused on face which is associated with significant adverse effects and poor awareness of these effects. The aim of this study was to assess the frequency of misuse of topical corticosteroids, the causes behind it and the most common adverse events resulting from it and to make aware the people about it</p><p class="abstract"><strong>Methods:</strong> This study was conducted at Dermatology Department of Govt. Medical College, Kota during period of one year from July 2015 to June 2016. A total of 670 patients using topical steroids over face were enrolled in the study. Details about the usage of topical corticosteroids and their side effects were recorded.<strong></strong></p><p class="abstract"><strong>Results:</strong> Majority of the patients were females (72.68%). The most common reason for misuse was melasma (57. 91%) followed by use as a fairness cream (22.38%). Most of the patient used topical steroid cream for duration of 3-6 months (33.13%). Most common age group was 21-30 years (48.20%). Acne form eruption (38.05%) and rebound erythema (28.20%) were the most common adverse effects noted. Patients were ignorant of the ingredients and their side effects.</p><p class="Default"><strong>Conclusions:</strong> Steroids have been misused by patients on their own or by pharmacist and non-dermatologist physicians for various reasons. Topical steroid should not be used on the face unless it is under strict dermatological supervision. </p>

scholarly journals Tinea incognito: Report of two cases

1970 ◽  
Vol 6 (3) ◽  
pp. 46-49
Author(s):  
SK Kedia ◽  
M Mathur
Keyword(s):  
Case Report ◽  
Fungal Infection ◽  
Clinical Presentation ◽  
Topical Steroid ◽  
Medical Sciences ◽  
Diagnostic Challenge ◽  
Over The Counter ◽  
Inappropriate Use ◽  
General Physicians ◽  
Tinea Incognito

Tinea incognito remains diagnostic challenge even to expert specialist because of modified clinical presentation caused by of inappropriate use of topical steroid. Topical steroid are being prescribed frequently for vary many dermatosis including fungal infection of skin and being used by patient as "over the counter drug" leading to varied clinical presentation of common dermatosis. This case report is of iatrogenic dermatosis that was invariably misdiagnosed by general physicians. Key words: Tinea incognito; dermatosis; fungal infection. DOI: 10.3126/jcmsn.v6i3.4076Journal of College of Medical Sciences-Nepal, 2010, Vol. 6, No. 3 pp.46-49

scholarly journals Improper Use of Topical Corticosteroids in Tinea Infections in a Tertiary Care Hospital

2021 ◽  
Vol 19 (1) ◽  
pp. 71-75
Author(s):  
Sushil Paudel ◽  
Niraj Parajuli ◽  
Sudip Chandra Dahal ◽  
Sudarshan Paudel
Keyword(s):  
Tertiary Care ◽  
Topical Steroids ◽  
Care Hospital ◽  
Over The Counter ◽  
Dermatology Department ◽  
Topical Corticosteroids ◽  
Regulatory Guidelines ◽  
Improper Use ◽  
Tinea Incognito ◽  
Topical Medications

Background: Steroid-modified tinea, also known as tinea incognito, is an infection by the dermatophytes, where the clinical morphology is modified due to corticosteroids, either systemic or topical. Rampant use of topical corticosteroids has led to increasing recurrence in tinea infections. Methods: All consenting cases of tinea presenting to outpatient department of dermatology department of Civil Service Hospital from March to August 2020 for a total of 6 months were included in this study. Tinea infection involving only the palms, soles, nails or scalp were excluded.Results: A total of 200 patients were included in this study. Among these, 175 patients (87.5%) were using topical corticosteroids. A significant association was noted between dermatophyte infection of more than one month and topical corticosteroids use (p<0.05). This study revealed that males were using super-potent topical corticosteroids more as compared to females (p<0.05). Moreover, no association was noted between the level of education attained and the use of topical corticosteroids (p=0.91). Only 25 (12%) patients were either using correct or no topical medications during the time of consultation with the dermatologist. Among the patients using topical corticosteroids, 155 (88.6%) patients were using them on recommendation of the local pharmacist and only 2 (1.2%) patients were prescribed by a physician. Conclusions: In short, use of topical steroids was rampant among patients with tinea whilst 77.5% patients procured steroid topicals over-the-counter. Hence, a tougher law and strict regulatory guidelines deemed necessary to curb the unauthorized and rampant sale of these medicines.Keywords: Dermatophytes; over-the-counter; steroid misuse; self-medications; tinea; topical corticosteroid

INCIDENCE OF CATARACT IN DERMATOLOGICAL PATIENTS USING STEROID CREAMS

2021 ◽  
pp. 65-66
Author(s):  
(Lt Col) Rajnish Kumar ◽  
(Lt Col) Vaka Raja Sekhar Reddy ◽  
(Lt Col) Sumit Kumar Singh ◽  
Debarshi jana
Keyword(s):  
Side Effects ◽  
Adverse Effects ◽  
Tertiary Care ◽  
Population Based ◽  
Topical Steroids ◽  
Study Group ◽  
Care Hospital ◽  
Ocular Side ◽  
Wide Range ◽  
The Face

Background/ Context: Corticosteroids, despite being a very effective line of treatment for various disorders is known to have a wide range of adverse effects. The use of systemic and topical steroids has been associated with cataract formation, however the ophthalmic side effects of application of steroid on skin away from the face has not been studied in depth. With increasing use of corticosteroids as rst line of therapy in treatment of various dermatological conditions, the ocular side effects, if any, of these preparations, cannot be overlooked. Aim: To study the incidence of cataract in patients using skin preparations of corticosteroids away from the face and also to correlate the dose and duration of steroid therapy to incidence of cataract. Materials & Methods: 50 patients with dermatological disorders who were being treated with dermatological steroids, on sites other than the face and periorbital region, for a period of more than six months consisted of the study group. The study group consisted of patients in the age group of 20 – 60 years. The study was conducted over a period of two years at a tertiary care hospital. Visual acuity, Slit lamp biomicroscopy, applanation tonometryand detailed fundus examination using 90D lens were carried out. Results: The incidence of cataract was signicantly higher in patients using dermatological steroids away from the face. Prolonged duration of use of these steroids also indicated a signicantly higher incidence of cataract. However, a larger population based study needs to be carried out to study the relationship between potency of steroid and incidence of cataract, although preliminary studies indicate a denite correlation between the two. Conclusions: Despite, steroids being used away from the face, there was a denite increase in the incidence of cataract. Before coming to any rm conclusions it would be advisable to reproduce the study in a larger population. However from the present pilot study it is prudent to advocate judicious use of innocuous looking steroid creams as they can cause signicant adverse effects

scholarly journals Clinical presentation and outcome of ectopic pregnancies in a tertiary care rural hospital

2019 ◽  
Vol 8 (2) ◽  
pp. 692
Author(s):  
Indu Verma ◽  
Punya Priya ◽  
Charvi Chugh ◽  
Harsharan Kaur ◽  
Dinesh Sood
Keyword(s):  
Ectopic Pregnancy ◽  
Rural Areas ◽  
Clinical Presentation ◽  
Tertiary Care ◽  
First Trimester ◽  
Rural Hospital ◽  
Reproductive Age ◽  
Age Group ◽  
Pain Site ◽  
Tract Infections

Background: Ectopic pregnancy is the commonest cause of the maternal morbidity and mortality in the first trimester of the pregnancy. The aim of this study was to see the clinical presentation, associated risk factors, mode of treatment and outcome.Methods: Retrospective study conducted in a tertiary care rural hospital. Women with diagnosis of ectopic pregnancy admitted between August 2016 to September 2018 were studied. Medical record files were scrutinized to get the details. Data was analyzed using Microsoft Office Excel (version 2007). Numerical data were subjected to descriptive analysis, with mean±standard deviation (SD) and categorical data as frequency and percentage.Results: Forty cases of ectopic pregnancy were included who were unbooked, non-smokers, married and belonged to rural areas. Eighty percent were in the age group of 20 to 30 years.  Maximum were gravida 3 or 4 with commonest presentation was pain, site was tubal. Laparotomy was done in 95% of women salpingectomy was the commonest surgical procedure done in 32 (80%) women. Salpingoophrectomy was done in one woman and lifesaving hysterectomy in 2 (5%) women for cervical and ruptured interstitial ectopic pregnancy one each. Blood transfusion was required in 28 (70%) women. No mortality was seen.Conclusions: Women of reproductive age group with pain abdomen and menstrual complaints, even without amenorrhoea, ectopic pregnancy should be ruled out. Treating reproductive tract infections / PID and offering contraceptives will decrease the incidence of ectopic pregnancy. Medical and paramedical staff should do the timely referral to higher centres.

scholarly journals Spectrum of ectopic pregnancy in tertiary care centre

2018 ◽  
Vol 7 (4) ◽  
pp. 1435
Author(s):  
Ishrat Zuber ◽  
Vaishali Chaurasia
Keyword(s):  
Ectopic Pregnancy ◽  
Clinical Presentation ◽  
Tertiary Care ◽  
Previous History ◽  
Stable State ◽  
Clinical Findings ◽  
Age Group ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Presenting Symptoms

Background: Ectopic pregnancy is a catastrophic and life-threatening condition and one of the commonest acute abdominal emergency in day-to-day practice. Objectives of present study were to know the incidence of Ectopic pregnancy at Tertiary care centre, the age group, parity and risk factor of ectopic pregnancy, the clinical presentation of ectopic pregnancy and the outcome and management of ectopic pregnancy.Methods: It was a retrospective study conducted at Chirayu Medical College and Hospital, Bhopal from 1st June 2009 to 31st May 2014. A total of 42 patients with ectopic pregnancy were analyzed on clinical presentation, clinical findings, investigations, operative findings and outcome.Results: A majority of women (64.29%) were in the age group of 21-30 years and 78.57% were multigravida. Commonest risk factors were previous history of abortion (23.80%) and pelvic inflammatory disease (14.28%) Amenorrhea (92.85%) and pain abdomen (89.22%) were the most common presenting symptoms. Ampulla of fallopian tube was the commonest site (45.23%). Unilateral salpingectomy was performed in 40.47% patients. There were no maternal deaths and majority (80.96%) were discharged within seven days.Conclusions: Ectopic pregnancy still remains one of the major causes of maternal morbidity and mortality. Early diagnosis and referral in hemodynamically stable state along with use of minimal access surgery or medical management can change the scenario of ectopic pregnancy in the developing world.

scholarly journals Clinical, Surgical and Outcome Predictive Factor Analysis of Operated Acute Subdural Hematoma Cases: A Retrospective Study of 114 Operated Cases at Tertiary Centre

2021 ◽  
Author(s):  
Rahul Singh ◽  
Ravi Shankar Prasad ◽  
Kulwant Singh ◽  
Anurag Sahu ◽  
Nityanand Pandey
Keyword(s):  
Retrospective Study ◽  
Subdural Hematoma ◽  
Surgical Outcome ◽  
Motor Response ◽  
Clinical Presentation ◽  
Tertiary Care ◽  
Acute Subdural Hematoma ◽  
Age Group ◽  
Female Ratio ◽  
Severity Of Injury

Abstract Objective To analyze clinical, surgical and outcome predictive factors of operated acute subdural hematoma (SDH) cases for prognostication and surgical outcome prediction. Material and Methods This retrospective study includes 114 patients operated for acute SDH in the Department of Neurosurgery of IMS BHU, Varanasi, India, a tertiary care center, between 1 August 2018 and 1 November 2019. Each patient was evaluated for age, sex, mode of injury, localization of hematoma, clinical presentation, comorbidity, severity of injury, best motor response, CT findings, and Glasgow outcome scale (GOS) at discharge. The outcome was also evaluated by further making a dichotomized group using GOS in death/dependent (1–3) versus independent (4–5). Statistical tests were done using the GraphPad Prism version 8.3.0. Results The most common age group operated upon in this study was the 40 to 60 years age group (n = 45, 39.48%). Males were 78% with male to female ratio of 3.56:1. The most common clinical presentation was altered sensorium (98.25%). The most common comorbidity was hypertension (n = 32, 28.07%). GCS at admission, severity of injury, pupillary changes, and best motor response (p < 0.0001) were significantly associated with surgical outcome. Conclusion GCS at admission, severity of injury, pupillary changes, and best motor response were significantly (p < 0.05) associated with surgical outcome. Age and gender of patients were not found to be significantly associated.

scholarly journals Onychomycosis: dermatophytes to yeasts: an experience in and around Mumbai, Maharashtra, India

2017 ◽  
Vol 5 (5) ◽  
pp. 1959 ◽  
Author(s):  
Rupali S. Suryawanshi ◽  
Shashir W. Wanjare ◽  
Avani H. Koticha ◽  
Preeti R. Mehta
Keyword(s):  
Tertiary Care ◽  
Local Area ◽  
Age Group ◽  
Female Ratio ◽  
Geographical Regions ◽  
Wide Range ◽  
Causative Agents ◽  
Male To Female ◽  
Nail Infection

Background: Onychomycosis is a fungal nail infection having wide range of prevalence in different geographical regions. It becomes imperative to know prevalent causative agent in local area to improve quality of life of patients. Present study was aimed to study epidemiological, clinical and laboratory aspects of onychomycosisMethods: Study was carried out prospectively at a tertiary care teaching hospital Nail scrapings of 630 clinically suspected cases of onychomycosis over a period of 5 years (January 2012 to December 2016) were subjected to KOH examination and culture.Results: Young adults in age group of 21-40 years (67.61%) were predominantly affected with male to female ratio of 1.8:1. Overall prevalence of onychomycosis of the present study is 58.41%. Yeasts were isolated in 47.86%, dermatophytes in 30.71% and non dermatophytic filamentous fungi in 21.43%Conclusions: Present study demonstrates a shift in causative agents from dermatophytes to yeasts. 

scholarly journals A CONCEPTUAL REVIEW OF KAPHAJA ABHISHYANDA / VERNALKERATO CONJUNCTIVITIS

2021 ◽  
Vol p5 (4) ◽  
pp. 2939-2944
Author(s):  
Priyanka Rani ◽  
Ekta Ramola ◽  
Gunjan Sharma ◽  
Renu Prasad
Keyword(s):  
Visual Impairment ◽  
Allergic Conjunctivitis ◽  
Clinical Presentation ◽  
Burning Sensation ◽  
Vernal Keratoconjunctivitis ◽  
Early Age ◽  
Age Group ◽  
Spring Season ◽  
Wide Range ◽  
Animal Dander

Kaphaja Netra Abhishyanda is defined in Ayurveda as the disease affecting all parts of the eye characterized by Guruta (heaviness of lids), Kandu (itching), Muhurmuhursrava (repeated lacrimation), photophobia and burning sensation in eyes etc. On reviewing the clinical presentation from modern texts, it is found that Vernalkerato conjunctivitis resembles with Kaphaja Netra Abhishyanda (conjunctivitis). Vernal keratoconjunctivitis is a type of allergic conjunctivitis which is a disease of early age group and becoming more important cause of corneal visual impairment and blindness. Vernalkerato conjunctivitis is the inflammation of conjunctiva caused by a wide range of allergens like pollens, dust and smoke, animal dander, mites or other allergy causing substance and is characterized by itching, hyperaemia and mild papillary reaction. This is also known as Spring Catarrh. ‘Spring catarrh’ nomenclature is indicative of season Vasant Ritu (spring season) which is the Kapha Prakopa period of the year as per the Ayurvedic principles and also the Kapha Prakopaka period of childhood age group. Keywords: Abhishyanda, Guruta, Kandu, photophobia, Muhurmuhursrava.

scholarly journals Tinea incognito with unjustified use of potent Topical Corticosteroids: a case series

2017 ◽  
Vol 6 (8) ◽  
pp. 2087
Author(s):  
Haiya J. Sheth ◽  
Santosh P. Rathod ◽  
Raju G. Chaudhary ◽  
Supriya D. Malhotra ◽  
Pankaj R. Patel
Keyword(s):  
Symptomatic Relief ◽  
Topical Steroid ◽  
Case Series ◽  
Superficial Infection ◽  
Steroid Abuse ◽  
Inappropriate Use ◽  
Monitoring Centre ◽  
Topical Corticosteroids ◽  
Chief Complaints ◽  
Tinea Incognito

Topical corticosteroids prescribed for various dermatological conditions, if used haphazardly have their adverse effects too, like aggravation of underlying infections - tinea, herpes etc. Tinea incognito is a fungal infection of skin masked and often exacerbated by application of topical immunosuppressive or steroid agent. Tinea incognito results because local physicians/chemists might mistake tinea with a simple rash. Availability of a topical steroid cream as an over the counter (OTC) drug is also one of the causes. Once it is diagnosed (clinically with or without KOH mount preparation), it should be thoroughly treated with oral and topical antifungal agents. Four cases presenting to Dermatology OPD VSGH with chief complaints of itching and aggravation of existing lesions due to application of potent topical corticosteroids like Clobetasol and Beclomethasone have been discussed here. They were diagnosed as cases of Topical Corticosteroids induced Tinea Incognito. The patients were recovering with oral and topical antifungals prescribed by dermatologist. These were also reported to nearest ADR Monitoring Centre under PvPI with Probable causality according to WHO UMC Criteria for Causality Assessment. The wide use of topical corticosteroids is due to its immediate symptomatic relief. However, the normal presentation of superficial infection gets altered with their inappropriate use. Lack of awareness among population, steroid abuse by local physicians or no strict regulations for local chemist shops have led to its inappropriate use. Its incidence ranges from 5-15%. These figures point towards the fact that implementation of appropriate regulations for the safe use of topical corticosteroids is essential.

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